[Dysphagia] Chlorhexidine

[eripley at yahoo.com (Irene Campbell-Taylor)]

<gjackson at rochester.rr.com> wrote
Can someone provide me with a reference to literature that says that 
50%
h2o2 is toxic to the oral mucosa?  I've seen it referenced several 
times on
the list, but all the research that I ahve read says the 
cholorhexedrine or
any alcohol based cleanser is the one to avoid  In the last year, we 
have
changed our oral care policies and now use 50% h2o2 or the Sage 
products
with peroximint
   
   The opposite is true. There are many recommended mouthwashes containing chlorhexidine.  The problem with hydrogen peroxide is not that it is ?toxic? but that it changes the pH of the mouth and can, therefore, promote the growth of some pathogens. See:
  The following is the information from Glaxo-Smith-Kline, manufacturers of Corsodyl, OTC chlorhexidine product that is, unfortunately, available only in Europe. ?Chlorhexidine gluconate is an antiseptic and disinfectant agent, which is active against various bacteria, viruses, bacterial spores and fungi. It kills the micro-organisms associated with various mouth and throat infections, and other common conditions in the mouth. These include the Candida albicans fungi that causes thrush infection in the mouth, and bacteria that may infect mouth ulcers or other sore areas in the mouth, eg after dental surgery. Infection of these areas increases discomfort and delays healing. Chlorhexidine has also been shown to prevent the formation and build up of plaque on teeth, which helps prevent inflammation of the gums (gingivitis). It can therefore be used as an aid to oral hygiene, particularly in instances where toothbrushing is a problem, eg following dental surgery or in
 physically or mentally handicapped people
   
  Oral Decontamination With Chlorhexidine Reduces Risk for Ventilator-Associated Pneumonia CME 
  News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFP
   
  Prevention of Nosocomial Infection in Cardiac Surgery by Decontamination of the Nasopharynx and Oropharynx With Chlorhexidine Gluconate 
  A Randomized Controlled Trial 
  Patrique Segers, MD; Ron G. H. Speekenbrink, PhD; Dirk T. Ubbink, PhD; Marc L. van Ogtrop, PhD; Bas A. de Mol, MD, PhD 
  JAMA. 2006;296:2460-2466. 
   
  CHG (Chlorhexidine gluconate) has the potential for fatal ARDS when aspiration occurs following ingestion. There is one such case reported following ingestion and reflux aspiration of 200ml CHG ? far more than is contained in any mouth wash.
   
   


Dr I Campbell-Taylor
Clinical Neuroscientist
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